Central Nervous System - Anxiety Flashcards
acute anxiety tx
benzodiazepines
chronic anxiety tx
SPECF
- Sertaline
- Propanolol
- Escitalopram
- Citalopram
- Fluoxetine
SSRI only alleviates physical symptoms
what can benzodiazepines induce?
hepatic coma esp long-acting so lowest dose for shortest time
which benzodiazepines are short acting?
- lorazepam
- oxazepam
lorazepam + oxazepam
when is short-acting benzodiazepines prefered?
- elderly
- hepatic impairment
what is short-acting benzodiazepines at a greater risk of?
risk of withdrawal symptoms (2-4wk)
which benzodiazepines are long-acting?
CCHAD
- clobazam
- chlordiazepoxide
- hydrochloride
- alprazolam
- diazepam
what are the s/e of benzodiazepines?
- paradoxical effects
- increased risk of sedation
- drowsy -> risk with driving
what are the paradoxical effects of benzodiazepines?
- aggression
- hostility
- talkative
- anxious
- excited
what increases the risk of sedation with benzodiazepines?
avoid concomintant use with:
- alcohol
- CNS depressant
- CYP inhibitors
which benzodiazepines have legal driving limit?
COLDFT
- clonazepam
- oxaepam
- lorazepam
- diazepam
- flunitrazepam
- temazepam
What is the benzodiazepine overdose tx?
flumazenil
what are the signs of dependence with benzodiazepines?
- anxiety
- sweating
- weight loss
- tremors
- loss of appetite
what are the 3 steps in withdrawing benzodiazepine medications?
1) convert all medications to one nightly dose of diazepam
2) reduce by 1-2mg or 1/10th of larger doses every 2-4WK - only further reduce if the symptoms of withdrawal is overcome
3) reduce further by 0.5mg near the end
